Solitaire stents for the treatment of complex symptomatic intracranial stenosis after antithrombotic failure: safety and efficacy evaluation

J Neurointerv Surg. 2016 Jul;8(7):680-4. doi: 10.1136/neurintsurg-2015-011734. Epub 2015 Jun 3.

Abstract

Objectives: To evaluate the feasibility, safety, and efficacy of Solitaire stent placement after balloon angioplasty for the treatment of complex symptomatic intracranial atherosclerotic stenosis (ICAS).

Methods: We retrospectively reviewed the clinical data from 44 patients who underwent Solitaire stent placement for complex symptomatic ICAS at our department between November 2010 and March 2014, with focus on the clinical factors, lesion characteristics, treatment results, and periprocedural complications. We also summarized the early outcomes and imaging findings during the follow-up period.

Results: Overall, the technical success rate was 100% (44/44). Post-stenting residual stenosis ranged from 0% to 40% (mean 15.00±12.94%). The overall 30-day rate of procedure-related complications was 9.09% (4/44). The incidence of recurrent ischemic events related to the territory artery was 4.55% during a mean clinical follow-up period of 25.5 months. Five patients (11.36%) developed in-stent restenosis during a mean angiographic follow-up period of 9.3 months.

Conclusions: This is the first case series study of ICAS treated by Solitaire stent placement. Deployment of a Solitaire stent with balloon angioplasty in the treatment of complex severe intracranial stenosis appears safe and effective, with a high technical success rate, relatively low periprocedural complication rate, and favorable outcome during follow-up.

MeSH terms

  • Adult
  • Aged
  • Angiography, Digital Subtraction
  • Cerebral Angiography
  • Cerebrovascular Disorders / diagnostic imaging
  • Cerebrovascular Disorders / etiology
  • Cerebrovascular Disorders / surgery*
  • Constriction, Pathologic
  • Endovascular Procedures / methods
  • Female
  • Fibrinolytic Agents / therapeutic use*
  • Follow-Up Studies
  • Graft Occlusion, Vascular
  • Humans
  • Intracranial Arteriosclerosis / complications
  • Intracranial Arteriosclerosis / diagnostic imaging
  • Male
  • Middle Aged
  • Recurrence
  • Retrospective Studies
  • Stents* / adverse effects
  • Treatment Failure
  • Treatment Outcome

Substances

  • Fibrinolytic Agents